Immortality Medicine

David Spiegelhalter’s proper title is Professor of the Public Understanding of Risk. He is in two minds (literally) about playing it safe or chucking caution to the wind. Decisions, decisions!? Are bacon sandwiches really that dangerous and is it wise to drive when you love cycling? David shows us how to use statistics to face up to life’s major risks.

Link via Flowing Data.

@ConanOBrien:

Peter Yarrow of the musical group Peter, Paul and Mary appeared on the CBS Early Show to sing a song he composed about his own colonoscopy:

In the video below, Dr. Paul Limburg, a Mayo Clinic Gastroenterologist, provides background on colorectal cancer and the screening methods:

Character strengths can be conceptualized in the Values-In-Action (VIA) strengths classification system.

135 undergraduate university students completed measures of strengths use, subjective well-being (SWB), self-esteem, self-efficacy, and health-related quality of life (HRQOL), and endorsed 5 top VIA strengths.

Results revealed that strengths use is a unique predictor of subjective well-being, but not HRQOL.

The VIA strengths of hope and zest were significant positive predictors of life satisfaction.

The most commonly-endorsed VIA strengths were:

- love
- humor
- kindness
- social intelligence
- open-mindedness.

The least-endorsed VIA strengths were:

- leadership
- perseverance
- wisdom
- spirituality
- self-control

The results suggest a link between VIA strengths and subjective well-being.

References:
Predictor of Well-Being and Health-Related Quality of Life. Journal Journal of Happiness Studies, 2010.

Where you live: It impacts your health as much as diet and genes do, but it’s not part of your medical records. At TEDMED, Bill Davenhall shows how overlooked government geo-data (from local heart-attack rates to toxic dumpsite info) can mesh with mobile GPS apps to keep doctors in the loop. Call it “geo-medicine.”

59% answered “yes”, according to the Case Western Reserve University (CWRU) poll.

Doctors are using Twitter to connect both with patients and other medical professionals.

Other doctors use Twitter to communicate with patients – generally not to give medical advice – but to guide the public to reputable sources of information, or share breaking medical news. The CDC, for instance, uses Twitter to provide constant updates on H1N1 influenza.

Finally, Twitter offers an opportunity for doctors to ask questions of other medical providers. Given the real-time nature of Twitter, opinions and answers to clinical issues can be obtained immediately.

Some doctors simply do not have enough time to Twitter, or utilize other social media applications like Facebook. And time spent with patients in the social media sphere is not compensated by health insurance.

But Twitter is a valuable way to reach thousands of people at once.

The Finnish orthopedic surgeon who operated on Beckham for 50 minutes on March 15 said the injury was a total rupture of Beckham’s left Achilles tendon. Beckham “probably knew there was no chance he could play [in the World Cup] when he arrived.”

His injury occurred late on during Sunday’s game against Serie A league opponents Chievo, as the apparent tendon rupture caused the midfielder to pull up while attempting to kick the ball, pain visible on his face.

Achilles rupture — a tearing of the tissue connecting the heel to lower leg muscles — can take months to heal, with physiotherapists advising weeks of rest before resuming even light exercise.

New therapies are needed to manage the increasing incidence, severity, and high rate of recurrence of Clostridium difficile infection.

A randomized, double-blind, placebo-controlled study included 2 neutralizing, fully human monoclonal antibodies against C. difficile toxins A (CDA1) and B (CDB1). The antibodies were administered together as a single infusion, each at a dose of 10 mg per kilogram of body weight, in patients with symptomatic C. difficile infection who were receiving either metronidazole or vancomycin.

Among the 200 patients who were enrolled (101 in the antibody group and 99 in the placebo group), the rate of recurrence of C. difficile infection was lower among patients treated with monoclonal antibodies (7% vs. 25%).

However, the mean duration of the initial hospitalization for inpatients did not differ significantly between the antibody and placebo groups (9.5 and 9.4 days, respectively).

The addition of monoclonal antibodies against C. difficile toxins to antibiotic agents significantly reduced the recurrence of C. difficile infection.

References:
Treatment with Monoclonal Antibodies against Clostridium difficile Toxins. Israel Lowy. NEJM Volume 362:197-205 January 21, 2010 Number 3.

Very severe chronic obstructive pulmonary disease (COPD) causes cor pulmonale – elevated pulmonary vascular resistance and secondary reductions in left ventricular filling, stroke volume, and cardiac output.

The authors of this NEJM study hypothesized that emphysema, as detected on computed tomography (CT), and airflow obstruction are inversely related to left ventricular end-diastolic volume, stroke volume, and cardiac output among persons without very severe lung disease.

Of the study participants, 13% were current smokers, 38% were former smokers, and 49% had never smoked.

A 10% increase in emphysema on CT was related to decrease in left ventricular end-diastolic volume, stroke volume, and cardiac output.

Percent emphysema and airflow obstruction were not associated with the left ventricular ejection fraction (LVEF).

Mind map of Chronic Obstructive Pulmonary Disease (COPD) (click to enlarge the image).

From the NYTimes:

During “choking game” adolescents try to achieve a high by briefly depriving the brain of oxygen through strangulation. The “game” is extremely dangerous and could lead to brain damage, long-term neurological disability and death.

According to the recent survey of more than 10,642 eighth graders in Oregon, 36.2 percent reported having heard of the choking game, 30.4 said they had heard of someone participating in it and 5.7 percent said they had participated themselves.

Many adults are unaware of the many names the game goes by — including “Knock Out,” “Space Monkey,” “Flatlining” or “The Fainting Game” — and the warning signs:

- bloodshot eyes
- marks on the neck that may look like hickies
- frequent severe headaches
- disorientation after spending time alone
- ropes, scarves and belts discarded on the floor or tied to bedroom furniture and doorknobs

References:
Choking Game No Mystery to Children, Oregon Study Finds. NYTimes, 2010.

Cutting U.S. salt intake by just half a teaspoon (3 grams) a day would prevent up to 92,000 deaths, 99,000 heart attacks, and 66,000 strokes — a benefit as big as smoking cessation. A 3-gm per day reduction in salt (1,200 mg of sodium) will result in 6% fewer new cases of heart disease and 3% fewer deaths.

Men who were single in the 1960s were 64% more likely to suffer a fatal stroke over the next three decades than their married counterparts.

The risk of fatal stroke was also 64% higher in men who reported dissatisfaction with their marriages than in men who rated their marriages as successful.

That figure is comparable to the risk of fatal stroke faced by men with diabetes.

References:
Single Men Have Higher Risk of Stroke. WebMD.

From Half Full: Science for Raising Happy Kids:

Let Kids Just Play: unstructured play time is actually more important than homework.

Children have lost 8 hours per week of free, unstructured, and spontaneous play over the last 2 decades due to homework.

Decrease in unstructured play time is in part responsible for slowing kids’ cognitive and emotional development. Today’s 5-year-olds had the self-regulation capability of a 3-year-old in the 1940s; the critical factor seems to have been not discipline, but play.

Pretend play is particularly beneficial, so make sure kids have ample time for it.

Image source: Child playing with bubbles. Wikipedia, Steve Ford Elliott, Creative Commons Attribution 2.0 License.

The exercises below have been adapted from a ProBlogger post. Most of the names have been modeled after popular social media services such as Twitter, RSS, Blogger, etc,

1. Cyber Squats. Set your chair aside for a few minutes and instead move to a semi-squat position with thighs parallel to the floor. Hold for 1 minute.

2. RSS Raises. As you’re sitting at your desk, straighten your knees and lift your legs out in front of you.

3. Ten Minute “Move it!” Break. Alternate jogging in place with jumping jacks – do a minute of each and repeat 5 times.

4. Twitter Tummy Tone. Tighten your abdominal muscles for 30 seconds and then release.

5. Social Squeezes. Tighten your gluteal muscles for 30 seconds and then release.

6. Ten Minute “Move it!” Break. Grab a step stool and climb up and down.

7. Inbox Incline. While you’re sitting with your feet on the floor, raise your heels so you are on the balls of your feet and lower them.

8. Ten Minute “Move it!” Break. Do walking lunges around the house. You can add some weights and do bicep curls at the same time.

9. Blogger Breather. Close your eyes and focus on your breath. Count to 10 as you slowly inhale through your nose, thinking positive thoughts. Exhale through your mouth, again counting to 10. Release all the tension and stress out of your body.

10. Sign Off Stretches. Shoulder shrugs – with your head at your chest, shrug your shoulders up and down. Neck Rolls – relax your shoulders and let your head roll forward. Slowly rotate your head in a circle. Repeat five times.

P ushups
S itups
L unges
S quats

Exercises that can be done with just body weight: PLSS.

domain.

18-year-old London teenager talks about life with the “silent killer” Hepatitis C and shares the dramatic story of how she came to be infected.

References:
Life with Hepatitis C for London’s teenage ‘It Girl’. CNN.

From the NYTimes:

“Distracted driving has gained much attention lately because of the inflated crash risk posed by drivers using cellphones to talk and text.

But phones aren’t just distracting drivers; they make pedestrians inattentive too.

Distracted walking combines a pedestrian, an electronic device and an unseen crack in the sidewalk, the pole of a stop sign, a toy left on the living room floor or a parked (or sometimes moving) car.

Examples include a 16-year-old boy who walked into a telephone pole while texting and suffered a concussion; a 28-year-old man who tripped and fractured a finger on the hand gripping his cellphone; and a 68-year-old man who fell off the porch while talking on a cellphone, spraining a thumb and an ankle and causing dizziness.”

References:
Forget Gum. Walking and Using Phone Is Risky. NYTimes.

You will get some ideas from the following conversation on Twitter:

@dreamingspires: I realised that a previous problem in my blog was that I was writing for people more qualified than me – instead of health professionals just starting out.

@DrVes: One of the best approaches to educational blogging is to write for yourself as you learn or write for beginners – which is basically the same thing.

@dreamingspires: good advice – as an(ex)publisher suddenly having to write myself as opposed to hiding behind someone else doing it is… a learning process.

@DrVes: Did Twitter help?

@dreamingspires: Twitter helped in the sense of connecting me into a community, I didn’t ‘micro-blog’ though.

@DrVes: Twitter makes you more comfortable to write in public – you don’t have to “micro-blog”…

@dreamingspires: This IS true and my experience – it reduced my stage fright!

@DrVes: Also, you may have micro-blogged on Twitter or somewhere else without even knowing it… I set up my blog posts to publish automatically in the future — it may help with your “stage fright”.

@dreamingspires: To be honest I am unsure what micro-blogging is — specific tweets on a topic like you do, or a mini conversation? Yes, I also now autopublish via Twitter feed, and now using Stumble too. OK – microblog is an ‘opinion’/link/statement.

@DrVes: Anything you post on Twitter is micro-blog as long it’s not only replies… A comment on a comment is not a blog. I think you qualify as a fully-fledged blogger and microblogger now…

@dreamingspires: You mean I’ve MADE IT?! Newbie happiness.

@DrVes: It’s official: You’ve made it. You’re a blogger now. Expect you share of nasty comments and spam…

Rob Centor:

The annual Perioperative Medicine Summit 2010 starts on March 4 in Miami:

http://periopmedicine.org and @PeriopSummit

I maintain their website for the University of Miami and Cleveland Clinic, and help with the Twitter account, hosting of PDF handouts, videos, etc.

Expect multiple free handouts posted on the front page of the summit website during March 4-6, 2010 and clinical pearls and discussions on Twitter: http://periopmedicine.org and @PeriopSummit

Help Your Heart With the Mediterranean Diet from ChefMD.

A new study finds the tea shows promise as a possible oral cancer fighter.

From Reuters:

Young men who smoked a pack of cigarettes a day or more had IQ scores 7.5 points lower than non-smokers in a study of over 20,000 Israeli military recruits.

“Adolescents with poorer IQ scores might be targeted for programs designed to prevent smoking,” concluded the researchers in the journal Addiction.

The average IQ for non-smokers was 101, while it was 94 for men who had started smoking before entering the military. IQ steadily dropped as the number of cigarettes smoked increased, from 98 for people who smoked one to five cigarettes daily to 90 for those who smoked more than a pack a day. IQ scores from 84 to 116 are considered to indicate average intelligence.

The study may suggest that lower IQ individuals are more likely to choose to smoke, rather than that smoking makes people less intelligent.

Dr Mike Cadogan – By definition non-smokers smarter than smokers…

Some interesting abstracts from PubMed:

“Google is an efficient web resource for identifying specific medical information.” Google was more efficient than all other resources for identifying medical information (P less than 0.0001) http://bit.ly/6FXATW

Google Scholar versus PubMed in locating primary literature to answer drug-related questions: no major differences http://bit.ly/8OygYt

A school based compulsory physical activity improved fitness and reduced adiposity in children. BMJ, Feb 2010.

Dr. Wes: Cardiology is easy until it isn’t

No doubt Mr. Cheney has had impecable cardiovacular care. But despite that care, after three bypasses, a history of atrial fibrillation, deep venous thrombosis, a cardiomyopathy that requires a defibrillator or two, and scores of medications to stabilize the angina – you’ve suddenly got a tough case: http://drwes.blogspot.com/2010/02/dick-vs-bill.html

PeRSSonalized Geriatrics from Webicina.com

http://www.webicina.com/perssonalized/?page=1&cat=37

PeRSSonalized Medicine is a free, easy-to-use aggregator of quality medical information that lets you select your favourite resources and read the latest news and articles about a medical specialty or a medical condition in one personalized place.

Hypertension is a “neglected disease”

“Although hypertension is relatively easy to prevent, simple to diagnose, and relatively inexpensive to treat, it remains the second leading cause of death among Americans,” said David Fleming, who led the study committee that wrote the report for the US Institute of Medicine. Hypertension is the most common primary diagnosis in the United States, affecting about 73 million adults (one in three).

http://www.bmj.com/cgi/content/short/340/feb22_2/c1074

Can’t Remember Faces? Blame Your Genes

The ability to remember a face is inherited, according to a paper in the Proceedings of the National Academy of Sciences. Researchers also found that people who are good at remembering faces are not necessarily good at other memory tasks. Face recognition ability comes from a dedicated circuit, or set of circuits, in the brain.

http://www.npr.org/templates/story/story.php?storyId=123975339&ft=1&f=1007

Erythropoiesis stimulating drugs caused tumours to grow faster and led to earlier deaths in some cancer patients, prompting the FDA to restrict their use.

http://www.bmj.com/cgi/content/short/340/feb22_2/c1050

Medical implications of the Taser: Serious harm is rare, but incident reporting needs to be improved

Amnesty International has identified more than 300 deaths associated with Taser use in the United States. However, association is not causation, and other factors complicate the interpretation of fatal outcomes. The dominant conducted energy device used in police forces worldwide is the Taser X26. This device generates five second trains of electrical pulses that are delivered to the body either by two propelled barbs (which embed in clothing or skin and remain connected to the handset by conductive wire) or by direct contact of the handset’s electrodes (drive-stun mode).

http://www.bmj.com/cgi/content/short/340/feb22_1/c853

Rational Or Emotional? After you’ve lost weight, you have an increase in the emotional response to food

One of the hormones that play a role in controlling appetite in the body is called leptin. After significant weight loss, leptin levels drop. This seems to signal to the brain a need to seek more food.

http://www.npr.org/templates/story/story.php?storyId=123894109&ft=1&f=1007

Image source: OpenClipArt.org, public domain.

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